Yoshida Mikako, Murayama Ryoko, Haruna Megumi, Matsuzaki Masayo, Yoshimura Kenichi, Murashima Sachiyo, Kozuma Shiro
Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, 113-0033, Japan.
Department of Nursing, The University of Tokyo Hospital, Tokyo, Japan.
J Med Ultrason (2001). 2013 Apr;40(2):125-31. doi: 10.1007/s10396-012-0396-1. Epub 2012 Sep 19.
To compare the pelvic floor function between women with and without stress urinary incontinence after vaginal delivery.
Seventeen women (age 35.5 ± 3.5) were prospectively studied at about 6 weeks, 3 months, and 6 months after vaginal delivery. Urinary incontinence was assessed by the International Consultation on Incontinence Questionnaire - Short Form. Pelvic floor function was assessed by antero-posterior diameter of the levator hiatus using transperineal ultrasound.
Five of 17 women experienced postpartum stress urinary incontinence. The antero-posterior diameter of the levator hiatus at rest was significantly longer in stress urinary incontinent women than in continent women until 3 months after delivery (p < 0.01), though shortening of the antero-posterior diameter of the levator hiatus was not significantly different between continent women and stress urinary incontinent women. Regardless of urinary incontinence, the antero-posterior diameter of the levator hiatus at rest shortened at 6 months postpartum, compared to 6 weeks postpartum (p < 0.001). The antero-posterior diameter of the levator hiatus during contraction had shortened only in continent women by 6 months postpartum (p = 0.02).
The extended pelvic floor may be a cause of stress urinary incontinence in the postpartum period. Therefore, treatment to improve the extended pelvic floor should be developed for the prevention of stress urinary incontinence.
比较经阴道分娩后有和没有压力性尿失禁的女性的盆底功能。
前瞻性研究了17名女性(年龄35.5±3.5岁),在阴道分娩后约6周、3个月和6个月进行评估。采用国际尿失禁咨询委员会简表评估尿失禁情况。使用经会阴超声测量肛提肌裂孔前后径来评估盆底功能。
17名女性中有5名经历了产后压力性尿失禁。在分娩后3个月内,压力性尿失禁女性静息时肛提肌裂孔前后径显著长于无尿失禁女性(p<0.01),尽管无尿失禁女性和压力性尿失禁女性肛提肌裂孔前后径的缩短情况无显著差异。无论有无尿失禁,产后6个月时静息时肛提肌裂孔前后径相较于产后6周时缩短(p<0.001)。仅在无尿失禁女性中,产后6个月时收缩时肛提肌裂孔前后径缩短(p=0.02)。
盆底扩张可能是产后压力性尿失禁的一个原因。因此,应开发改善盆底扩张的治疗方法以预防压力性尿失禁。